Provider Demographics
NPI:1386017432
Name:VIVBEHAVIOR ANALYSIS SERVICES,INC
Entity Type:Organization
Organization Name:VIVBEHAVIOR ANALYSIS SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCABA
Authorized Official - Phone:786-515-7166
Mailing Address - Street 1:1801 NE 140TH ST APT 205
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-1313
Mailing Address - Country:US
Mailing Address - Phone:786-515-7166
Mailing Address - Fax:
Practice Address - Street 1:1801 NE 140TH ST APT 205
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-1313
Practice Address - Country:US
Practice Address - Phone:786-515-7166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-10
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-11-4185320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities